However, a brewing war of words over the rules has developed between HHS Secretary Mike Leavitt and two professional associations representing doctors, nurses and other health care workers.

Writing in his blog Aug. 21, Leavitt repeated his claim that the rules were necessary, in part, to head off an effort by the associations to require a doctor to perform abortions in order to be considered competent. Leavitt has made the claim throughout 2008, much to the dismay of the American College of Obstetricians and Gynegologists, a professional association, and the American Board of Obstetrics and Gynecology, which certifies physicians.

Since March ACOG has been sending a letter to members who have raised questions about any such requirement to clarify the organization’s stance.

The letter, signed by Dr. Hal Lawrence, ACOG’s vice president, practice activities, maintains that the association’s Ethics Committee “affirms the importance of a physician’s conscience in shaping ethical and professional conduct.” He cites similar opinions from the American Medical Association Council on Ethical and Judicial Affairs, International Federation of Gynecology and Obstetrics and the World Health Organization.

Gant asked Leavitt to produce “even one” instance of discrimination based on a decision of conscience of which he accuses the the board. He reminded Leavitt that the board’s requirements for certification/recertification comply with federal law. He also urged Leavitt to conduct hearings on the regulations to allow ABOG to publicly clarify its role in the certification of physicians.

To date, the rules have been published in the Federal Register, giving anyone a chance to comment on them until Sept. 20.